The lasting impact of incarceration: A qualitative thematic analysis of mental health in formerly incarcerated Black men

Black men in the United States face high incarceration rates and formerly incarcerated Black men (FIBM) have worse mental health outcomes than Black men who have never been incarcerated. Incarceration is a driver of population health inequities and as such, its role in contributing to negative mental health outcomes must be examined within FIBM's broader social, environmental, and historical context. The purpose of this study was to examine FIBM's perceptions of mental health broadly, and in relation to their lived experiences with incarceration. In-depth semi-structured interviews were conducted with 29 FIBM in Philadelphia, PA. Reflexive thematic analysis was used to analyze interview transcripts. Five themes were generated in analysis: 1) “Defining mental health” 2) “Mental health harms during incarceration,” 3) “Incarceration and its harms persist,” 4) “Redefined relationships and roles,” and 5) “Navigating place.” Together these themes reveal the extent to which mental health of FIBM is influenced by social, environmental, and structural aspects of their individual lived experiences, which is largely shaped by the shared experience of incarceration. Incarceration has a direct and persistent impact on FIBM's mental health and lived experiences, and a pervasive influence on the larger context in which they are embedded, including their social relationships and physical environment. It is essential to examine the mental health of FIBM through the context created and influenced by incarceration to effectively understand and address their mental health needs.